1. Maryland KEEP: An Evidence-Based Approach to Promoting Permanency & Child Well-Being
Elizabeth J. Greeno, PhD, LCSW-C; Richard P. Barth, PhD, MSW; Mathew C. Uretsky, MSW, MPH; Terry V. Shaw, PhD, MSW, MPH; Jessica E. Moore, MA
Summary & Discussion
Background & Purpose
Results
60% of children had a positive exit from child welfare
PDR behaviors were higher at baseline than what had been reported in previous literature but still significantly decreased; an average of 7 problems at baseline and only 3 at posttest (p <.0001)
CBCL decreased from clinically sign. & borderline ranges
Discipline & Supervision changed after participation in the KEEP program; a 30% increase from baseline to post in terms of ratio of daily positive reinforcement to discipline techniques with a ratio of 5 positive behaviors to 2 discipline techniques
KEEP had a substantial impact on permanency and placement stability for a high externalizing behavior child welfare population who had been in care approximately 3.4 years.
KEEP is a training and support program that that helps parents of children ages 5-12 to learn and implement evidence based behavior management strategies designed to reduce tough behaviors and prevent disruptions in placement. In previous implementations, the program significantly reduced the number of child behavior problems reported by parents, increased the proportion of positive reinforcement to discipline and reduced the risk of placement disruption (Price, Roesch & Walsh, 2012; Leathers, 2011; Buchanan, Chamberlain, Price & Springelmeyer, 2013). The purpose of this study is to examine effects of a KEEP intervention in a high-behavioral display kinship and foster care population on child behavior problems, parenting style, and placement stability.
KEEP Model
Cohort & # Children
N = 57
Median Length of Stay in Care Prior to KEEP (in days)
Median Length of Time in care till Implementation (in days)
Total # of kids who exited after KEEP
Median Time from End Implementation to Exit (in days)
Reunif.
Adopts.
Guards.
1 (6)
1342
(Range )
441
(Range ) 2
170
(Range ) 1
2 (5)
1133
(Range )
628
(Range ) 4
324
(Range 1-918) 3
3 (7)
1258
(Range )
631
(Range ) 5
464
(Range )
4 (8)
1043
(Range )
505
(Range ) 6
413
(Range )
5 (7)
1299
(Range )
779
(Range )
283
(Range )
6 (8)
1986
(Range )
1464
(Range )
370
(Range )
7 (5)
946
(Range )
536
(Range )
347
(Range )
8 (5)
1070
(Range )
632
(Range )
193
(Range 2-384)
9 (6)
968
(Range )
623
(Range )
202
(Range )
Totals
Average: 1258
[3.4 years]
(Range )
718
2 years]
(Range ) 34
336 8 15 11
Meet as a group one time per week for 16 weeks
Sessions are 90 minutes
Fun informal environment
Snacks, drinks served and child care provided
Two facilitators (lead and co)
Home practice every week
Parent phone contact weekly
Missed sessions get home visit
Parents are seen as the key to changing child behavior
Methods
Pre-test data on parenting practices and child behaviors were administered over three phone calls prior to the start of the KEEP training. Nine trainings where held during the study time period. Sixty-five caregivers completed all three of the baseline calls. The same measures were used over two phone calls at post-test, approximately 2 months after the completion of the KEEP training (5-6 months after the initial KEEP training). At post-test, only 51 of the 65 caregivers could be reached to complete the follow-up data collection. Of these, 39 were still caring for the child of interest. Attrition of the 14 caregivers was due to a lack of response to multiple telephone contact attempts. Measures included:
Discipline & Supervision Measure
Parent Daily Report
Child Behavior Checklist
Child Welfare Administrative Data